Evaluation of a Comprehensive Pro-Active Intervention on Quality of Life for Community Frail Older Adults

Sunday, 30 July 2017

Yen-Chun Lin, PhD, RN
Lian-Hua Huang, PhD
Meei-Fang Lou, PhD, RN
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan

Purpose:  To evaluate a comprehensive pro-active intervention for community frail older adults and examine its effectiveness.

Methods: This is a pilot experimental study. The older adults who consented and met the frail or pre-frail status assessed by Fried Frailty Criteria were randomly assigned into experimental (N=55) and control groups (n=54). The experimental group received a 6-month comprehensive pro-active intervention. We provided a comprehensive assessment for each participants. Based on their individual needs, we provided physical activity practice, health education, community resource referrals, community support groups, group community activity participation, counseling, self-management skills teaching, regular telephone follow-up, and home visits every two weeks or monthly. The control group received the usual primary care. Both the intervention and control groups completed the Health Related Quality of Life (WHOQOL-BREF) at baseline and again at a 6-month follow up. Analysis of covariance (ANCOVA) was used to compare the outcome across groups with post-test as outcome and baseline values as a covariate.

Results:  There were 109 clients participated in this study. The overall average age of participants was 76.96 years old. The 57.8% participants were male. Assessed by Fried Frailty Criteria, 12 participants (11.0%) were frail, and 97 participants (89.0 %) were pre-frail. During the research process, 7 participants in experimental group and 8 participants in control group withdraw from the study. Finally, 48 participants in experimental group and 46 participants in control group completed the post-test. The differences of mean scores of quality of life between pre and post-test were assessed by paired t-test. The results showed that quality of life of post-test in experimental group were improved compared to that of pre-test except for social relationship domain. After adjusted the pre-test scores, the results showed that the mean scores of quality of life for physical domain in experimental group were statistically increased compared to that of control group (F=5.343, p=0.023).

Conclusion: The results showed that the interventions were significantly improved the quality of life for physical domain. Future research to investigate effective interventions for other domains is recommended.